National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 53484

Government Disclaimer on use of this data



Case Details

VAERS ID: 53484 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Illinois  
Vaccinated:1993-05-19
Onset:0000-00-00
Submitted: 1993-05-20
Entered: 1993-06-01
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2H31039 / 2 LL / IM
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER 68515OK / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M100HP / 2 RL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. G0210 / 2 LL / IM

Administered by: Public       Purchased by: Public
Symptoms: Anorexia, Apnoea, Cardiac arrest, Cough, Petechiae, Rhinitis, Sudden infant death syndrome
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-05-20
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: IL93082

Write-up: most likely unrelated but pt died of SIDS; pt exposed to HIV; born premature 30 wks gestation;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=53484


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166